strengthen irritated muscles at the outset by further
use, but by temporarily putting them at rest by relieving the strain of the posterior musculature.
A properly fitting corset with a tight pelvic hold not
only improves balance, but incidentally serves as a splint
and support. The blacksmith who is to do heavy work
with his arm puts a leather strap around his wrist to
enable his muscles to work to better advantage. He
gains. thereby an extra annular ligament.
Proper corsets, then, accomplish three things in the
relief of this condition:
- . They tend to corred vicious balance by carrying the center of gravity backward, thus relieving muscular shain.
- . They partially splint the lower back.
- . They furnish an artificial annular ligament to the glutei museles.
High-heeled shoes are also to be recommended temporarily,
when comfortable to the patient, because experimental
observation has shown that they carry back the
center of gravity, and clinical experience is generally
confirmatory of their good effect.
If lateral deviation of the spine exists, it is to be
improved by an extra lift on the shoe of the side to
which the body leans.
In the more severe cases the actiye day should be a
short one and recumbency for some hours during the
day should be insisted on. It is only necessary to allude
to the fact that the general condition of the patient
must, of course, he attended to from the outset. After a
week or two of such treatment, aimef1 at resting tired
and irritated muscles, the patient is generally ready for
the second stage of the treatment. mmeular development
as a means to the attainment of a permanently correct
attitude. In irritable cases the exercisès should be given
at first in the recumbent position and later only in the
erect position. The whole temleney of most medical
gymnasts is to overdo hoth the massage and exercise at
first. It must be remembered that the maximum museular
stimulation from massage is reached at the end of five
minutesl0 and that, after that, deterioration of muscular
strength follows. Increase of backache following the
execises is a sign of too active exercises or too long a
period of them. They are hest taken once a day, the
length of the period being gradually inereased.
It must be admitted that, irrational as it is, many
cases of backache are relieved try the use of corsets and
hig-heled shoes aloue. In a larger number this is a
most useful preliminary to further attempts at radical
cure, and we mUcit remember that we shall be really
curing such patients only when we have found and
removed the condition which cansed the disturbance of
balance induring the bark-strain.
CONCLUSIONS
We beliere that static backache is essentially a
mechanical disorder; that is, that it is the result of loss
of balanee producing local strain on the tissues in the
lumbosacral region and elsewhere in the posterior musculature.
We further belieye, nnd regard it is our most
essential point, that whatever the local mechanism which
produces the symptoms may be, such backache is in a
large proportion of all cases not a disease in itself (as
suggested by such terms as "hysterical spine," "relaxation
of the sacro-iliac joints," etc.), hut is a mere symp-
10. McKenzie: Exerise in Education and Medicine, Philadelphia, 1909, p. 47.
|
tom-complex due to an abnormal attitude induced by
peculiarities of the skeleton, lack of proper muscular
balance, or abnormal conditions in the abdomen or elsewhere.
We believe that in diagnsis the local condition
should be regarded as primary only after every cause
elsewhere has been exeluded.
321 Dartmouth Street-234. Marlborough Street.
|